Frozen Shoulder: Causes, Symptoms, Diagnosis And Treatment

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and a significant reduction in the range of motion of the shoulder joint. This condition develops gradually and can severely impact daily activities.

The shoulder joint is enclosed in a capsule that holds the bones, ligaments, and tendons together. When this capsule becomes inflamed, thickened, or shrinks, it restricts movement and leads to a frozen shoulder. The condition typically progresses through three stages:

1. Freezing Stage: Increasing pain and gradual loss of motion.
2. Frozen Stage: Stiffness becomes more prominent, with a slight reduction in pain.
3. Thawing Stage: Gradual improvement in mobility and reduction in stiffness.

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Causes of Frozen Shoulder

Several factors influence the development of a frozen shoulder, including:

• Shoulder Injuries: Conditions like tendinitis, bursitis, and rotator cuff injuries can lead to inflammation, increasing the risk of a frozen shoulder.
• Arthritis: Osteoarthritis and rheumatoid arthritis affecting the shoulder joint may contribute to stiffness and pain.
• Prolonged Immobility: Lack of movement due to conditions such as stroke, broken arm, or surgeries involving the chest or breast can result in a frozen shoulder.

Risk Factors

Certain individuals are more susceptible to developing frozen shoulder. The common risk factors include:

• Age: More commonly seen in people above 40 years old.
• Gender: Women are more prone to experiencing frozen shoulders than men.
• Medical Conditions: Underlying diseases such as diabetes, cardiovascular diseases, hyperthyroidism, hypothyroidism, stroke, and Parkinson’s disease increase the likelihood of developing this condition.
• Reduced Shoulder Movement: Immobilization due to injury, surgery, or a sedentary lifestyle can contribute to stiffness in the shoulder joint.

Signs and Symptoms

The primary symptoms of a frozen shoulder include:

• Persistent pain in the shoulder joint.
• Gradual reduction of mobility in all directions.
• Stiffness that worsens over time.
• Pain that may extend to the upper arm.
• Difficulty in performing routine tasks like reaching overhead or behind the back.

Diagnosis and Tests

A frozen shoulder is often diagnosed based on symptoms and a physical examination. Your doctor may suggest additional tests to rule out other conditions:

• X-rays: Helps detect arthritis or any structural abnormalities.
• MRI (Magnetic Resonance Imaging): Useful for identifying soft tissue injuries and inflammation.
• Arthrography: A special imaging technique that involves injecting dye into the joint to get a detailed view of the shoulder capsule.

Treatment and Management

Managing a frozen shoulder involves relieving pain, improving mobility, and restoring function. Treatment options include:

1. Medications

• Over-the-counter pain relievers like ibuprofen or acetaminophen.
• Corticosteroid injections to reduce inflammation and pain.

2. Physiotherapy

• Stretching and strengthening exercises help regain motion.
• Physical therapy plays a crucial role in preventing further stiffness.
• Gentle movements guided by a physiotherapist can promote healing and mobility.

3. Surgery

In serious cases where conservative therapy fails, surgical procedures may be considered:

• Manipulation Under Anesthesia (MUA): The doctor moves the shoulder joint forcefully while the patient is under anesthesia to break adhesions and improve mobility.
• Arthroscopic Surgery: A minimally invasive procedure where small instruments are used to remove adhesions and scar tissue inside the shoulder joint.

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Alternative Therapies

Some individuals find relief through alternative treatment methods such as:

• Acupuncture: Insertion of fine needles at specific points to relieve pain and improve movement.
• Acupressure: Application of pressure on key points to reduce discomfort.
• Hydrotherapy: Water-based exercises that help in reducing stiffness and improving mobility.

Preventive Measures

While a frozen shoulder cannot always be prevented, certain precautions can help reduce the risk:

• Maintain Shoulder Mobility: Regular stretching and movement help prevent stiffness.
• Physical Therapy: If you’ve had a shoulder injury or surgery, follow recommended physiotherapy exercises to maintain mobility.
• Early Intervention: If you experience shoulder pain, seek medical advice promptly to prevent the worsening of the condition.

Conditions That Mimic Frozen Shoulder

Frozen shoulder can sometimes be mistaken for other shoulder conditions. These include:

• Arthritis: Joint inflammation that leads to pain, swelling, and stiffness, mimicking frozen shoulder symptoms.
• Rotator Cuff Injuries: Tears or inflammation in the tendons surrounding the shoulder joint can limit movement but usually do not restrict motion in all directions like a frozen shoulder.

Final Thoughts

Frozen shoulder is a painful and limiting condition, but with proper treatment and management, recovery is possible. If you experience persistent shoulder pain and stiffness, consult a healthcare professional to determine the best course of action. Early intervention, regular exercises, and appropriate medical care can help restore mobility and improve quality of life.